AUTHOR=Alkaabi Juma , Afandi Bachar , Alhaj Omar , Kanwal Darakhshan , Agha Adnan 

TITLE=Identifying metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes mellitus using clinic-based prediction tools

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1425145

DOI=10.3389/fmed.2024.1425145

ISSN=2296-858X

ABSTRACT=Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD) is a global cause of chronic liver disease. The prevalence of MASLD is high in patients with type 2 diabetes mellitus (T2DM).  Various noninvasive tools like fibrosis-4 index (FIB-4) and NAFLD-fibrosis score (NFS), liver ultrasound, and Fibroscan can aid in the detection of liver fibrosis in MASLD, while the Hamaguchi ultrasound-based liver grading system has demonstrated high sensitivity and specificity comparable to liver biopsy.

Objective: We assessed the frequency of MASLD in patients with T2DM using liver ultrasound Hamaguchi score and the accuracy of NFS and Fib-4 in identifying MASLD.

Patients and methods: We retrospectively collected data and reviewed the charts of all patients with T2DM who underwent liver ultrasound and laboratory tests, during the past 5 years.

Results: A total of 6214 medical records were screened, and only 153 patients (68.6% females; mean age, 59 ± 12.2 years) fulfilled the selection criteria.  MASLD was diagnosed using the Hamaguchi grading criteria in 45.1% of patients. A high/intermediate NFS had higher sensitivity (79.7%) for diagnosing MASLD, with specificity of 10.7%, while high/intermediate Fib-4 score showed only 30.4% sensitivity but higher specificity of 54.8%.

Conclusion: Our study indicates that MASLD is frequent in patients with T2DM and clinical prediction tools like NFS and Fib-4 can be applied in clinic/primary care setting with variable results.